Exclusive: Healthcare professionals not challenging families when they refuse vaccines for vulnerable relative, sources claim
People with learning disabilities and early people with dementia are being denied vaccines by antivaxxer carers and families, as concerns are raised over gaps in NHS’ oversight over this group.
Several reports have been received by The Independent warning vulnerable people, such as those with severe learning disabilities, who lack mental capacity are being denied vaccines by carers and family members.
The news comes following reports people with severe learning disabilities are struggling to receive a Covid booster despite being within one of the six priority groups.
Legal experts have raised concerns healthcare professionals are failing to challenge these refusals as they are required to do, while in some cases where the decision is challenged it is taking months to reach the Court of Protection.
One senior GP leader has also suggested current loopholes in the NHS’ recording of vaccines system mean vaccine centres are easily able to avoid challenging families where they refuse vaccines for a vulnerable patients.
Aasya Moghul director of Mental Capacity Act training firm, Edge Training told The Independent: “We have heard of numerous examples of people that the lack mental capacity to give or refuse consent to the Covid-19 vaccination, not being vaccinated because a relative objects.
“Regrettably, in these examples the professionals involved in the person’s health and social care did not take the steps necessary to make a prompt application to the Court of Protection. In some cases, the person contracted Covid-19 and subsequently died. This is not about blaming families in any way. This is about the gaps in professional practice because of a lack of knowledge and awareness of the steps they should take when such a dispute arises.”
She added relatives may have reasonable reasons to object to the vaccine for their loved ones but in these circumstances if the vaccine is considered to be in the person’s best interests by a medical professional an application should be made to the Court of Protection.
Speaking with The Independent a social worker in London said she’d had two cases in recent months where an elderly patient, with dementia, had not received their vaccines after the family refused.
She said the care home she worked with were not aware they had to carry out a mental capacity assessment and have a doctor do this and a best interests assessment carried out and so the patients went unvaccinated.
According to the senior GP leader in London there was a big variation in decline rates across GP practices and CCGs for patients in priority group six and four, which include people with learning disabilities and long term health conditions.
Internal data for his group of several practices showed a 10 per cent different in some practice’s decline rates across this group, with some of the practices showing “huge” decline rates.
The GP leader said in practices with higher decline rates: “I think people have been lazy in not chasing for consent of hard to reach groups, they’ve got high unvaccinated rates that don’t look good so just mark them as declined if they don’t respond. As soon as they’re marked as declined, they’re taken of the yet to be vaccinated list.”
“With people who might be on the learning disability list or have had past issues with consent we need to be more careful with that. Some practices may do it because they get criticised (over vaccine rates), for example there was a national push on the worst performing areas for vaccination in the autumn. The way the rules work is that when a patient has declined, their stats immediately improve.”
Meanwhile when families are challenged recent examples heard by the Court of Protection have shown it has taken months for decisions to me processed.
In a recent case heard on 17 December the Court of Protection ruled it was in the best interest for a woman with severe learning disabilities to have the Covid vaccines, after her parent initially refused to allow it. Although the woman should have had her vaccine in May the case was only heard in December.
In reports of a case heard on the 23 December a judge criticised delays in health and care services making an application to the court after a man in his 30s with severe cerebral palsy and learning disability did not receive a vaccine as his mother objected, according to website Open Justice.
Speaking with The Independent Oliver Lewis, a barrister who has appeared in Court of Protection vaccination cases, said: “Unless they’re the disabled person’s health and welfare attorney or deputy, no one – not even a close relative – has a veto over whether a disabled person receives a vaccination.”
“If a person says no to vaccination of their disabled relative, clinicians should follow the Mental Capacity Act if they believe the disabled person lacks capacity to decide on the vaccination.”
“If there is a dispute about capacity or best interests in terms of vaccination, the GP or their CCG should make an urgent application to the Court of Protection to make decisions. Failure to do that may well be unlawful.”
“People with learning disabilities became eligible to receive their first vaccination in May 2021. The Court of Protection should have dealt with all these vaccination cases months ago, given what we know about the effect of Covid on people with learning disabilities and the lifesaving potential of vaccines.”
Dan Scorer, head of policy and public affairs at the learning disability charity Mencap, said: “Throughout the pandemic, research has shown that people with a learning disability are more likely to die from Covid than the general population and the vaccine is an important way to protect people.
“The decision to have the vaccine or not is an individual one. The Mental Capacity Act starts from the principle that people with a learning disability are assumed to have capacity to make their own decisions and should be supported to do so in a way that is suitable for their individual needs.”